High-grade glioma in elderly patients: can the oncogeriatrician help?

Clin Interv Aging. 2013:8:1617-24. doi: 10.2147/CIA.S35941. Epub 2013 Dec 6.

Abstract

Gliomas are the most frequent primary brain tumors in adults. As the population ages in Western countries, the number of people being diagnosed with glioblastoma is expected to increase. Clinical management of elderly patients with primary brain tumors is difficult, owing to multiple comorbidities, polypharmacy, decreased tolerance to chemotherapy, and an increased risk of radiation-induced neurotoxicity. A few specific randomized studies have shown a benefit for radiotherapy in elderly patients with good performance status. For patients with poor performance status, chemotherapy (temozolomide) has been shown to be associated with prolonged duration of response. Patients with methylated O (6)-alkylguanine deoxyribonucleic acid alkyltransferase promoter seem to have better outcomes. Oncogeriatrics proposes the geriatric evaluation of elderly patients to improve therapeutic choices and optimize the management of treatment toxicities and comorbidities.

Keywords: brain tumor; chemotherapy toxicity; older cancer patient; oncogeriatric charter.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Aged
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / drug therapy
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / surgery
  • Brain Neoplasms / therapy*
  • Combined Modality Therapy
  • Dacarbazine / analogs & derivatives
  • Dacarbazine / therapeutic use
  • Glioma / diagnosis
  • Glioma / drug therapy
  • Glioma / radiotherapy
  • Glioma / surgery
  • Glioma / therapy*
  • Humans
  • Prognosis
  • Temozolomide

Substances

  • Antineoplastic Agents, Alkylating
  • Dacarbazine
  • Temozolomide